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Clinical and Laboratory Factors Predicting the Prognosis of Patients with COVID-19: An Analysis of 127 Patients in Wuhan, China

30 Pages Posted: 5 Mar 2020

See all articles by Tao Bai

Tao Bai

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Shengjin Tu

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory

Yuan Wei

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory

Li Xiao

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Yan Jin

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Lei Zhang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Jun Song

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Weihua Liu

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory

Qingjing Zhu

Wuhan Jinyintan Hospital - Liver and Infectious Diseases Department

Ling Yang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Hua Chen

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory

Xiaohua Hou

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

More...

Abstract

BACKGROUND: Corona virus infective disease 2019(COVID-19) is an emerging infectious disease that first outbreak in humans in China in December 2020 and has subsequently spread worldwide. This study aimed to describe and evaluate the clinical and laboratory indexes to predict the outcome of COVID-19.

METHODS: Consecutive patients with confirmed COVID-19 admitted to Jinyintan hospitals in Wuhan, China were included from December 26 to January31 2020. All patients had definite clinical outcome (discharge or death) before February 10. The area under the receiver operating characteristic curve (AUC) of subjects was used to evaluate the prediction efficiency of laboratory parameters. Multiple logistic regression was used to evaluate the independent prognostic factors.

FINDINGS: The study included 127 hospitalized patients with confirmed COVID-19, with 91 cured and 36 died patients. The most common complications of COVID-19 death were acute cardiac injury (21 patients, 58.3%), ARDS (20 patients, 55.6%), coagulation dysfunction (14 patients, 38.9%), and acute kidney injury (12 patients, 33.3%). Died patients was more likely to have multiple organ dysfunction syndrome (p<0.001). The died patients had deteriorated at-admission liver and kidney function, tissue damage related biomarkers (lactate dehydrogenase, creatine kinase and troponin I) , prolonged prothrombin time. The inflammatory biomarkers, including c-reactive protein, ferritin, procalcitonin and interleukin-6 (IL-6) levels also significantly increased. The area under the receiver operating characteristic curve (AUC) showed that at-admission CD3 positive-, CD4 positive- and CD8 positive- lymphocyte counts had good prognostic values for clinical outcomes (AUC=0.915, 0.886 and 0.870, respectively) while lymphocyte counts in blood routine test was moderate (AUC=0.732). Moreover, the prognostic values of lactate dehydrogenase, troponin I, prothrombin time, and procalcitonin were good (AUC=0.928, =0.939, =0.920, and =0.900, respectively. Multiple regression model showed that CD3+ lymphocyte counting ≤470/ µl, prothrombin time≥13.5 s and procalcitonin≥0.15 ng/ml were independent prognostic factors for death.

INTERPRETATION: The predictive effect of CD3+ lymphocyte typing count on the clinical outcome of COVID-19 was better than that of routine lymphocyte count. Elevated at-admission procalcitonin and prothrombin time were independent prognostic factors for death.

FUNDING STATEMENT: Urgent projects of scientific and technological research on COVID funded by Hubei province

DECLARATION OF INTERESTS: The authors declare no competing interests.

ETHICS APPROVAL STATEMENT: This study was approved by the Institutional Ethics Board of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Jinyintan Hospital.

Keywords: Novel coronavirus disease 2019; SARS-CoV-2;outcome; prognostic value;laboratory Parameters

Suggested Citation

Bai, Tao and Tu, Shengjin and Wei, Yuan and Xiao, Li and Jin, Yan and Zhang, Lei and Song, Jun and Liu, Weihua and Zhu, Qingjing and Yang, Ling and Chen, Hua and Hou, Xiaohua, Clinical and Laboratory Factors Predicting the Prognosis of Patients with COVID-19: An Analysis of 127 Patients in Wuhan, China (2/26/2020). Available at SSRN: https://ssrn.com/abstract=3546118 or http://dx.doi.org/10.2139/ssrn.3546118

Tao Bai (Contact Author)

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

China

Shengjin Tu

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory ( email )

China

Yuan Wei

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory ( email )

China

Li Xiao

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

China

Yan Jin

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

China

Lei Zhang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

China

Jun Song

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

China

Weihua Liu

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory ( email )

China

Qingjing Zhu

Wuhan Jinyintan Hospital - Liver and Infectious Diseases Department ( email )

Wuhan, 430023
China

Ling Yang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

China

Hua Chen

Wuhan Jinyintan Hospital - Department of Tuberculosis and Respiratory ( email )

China

Xiaohua Hou

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

China

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